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Stormwater Management Questionnaire For <br /> p <br /> Single Family Residential / Duplex / Small Proj-c <br /> Step 1: Fill in the Quantities below: <br /> The total amount of proposed hard surfaces(rooftop,pavement, etc.)for my project site is: •� ir— S.F. (Box 1) <br /> The amount of existing hard surfaces on my project site that will be removed or replaced is: S.F. (Box <br /> The amount of net new hard surfaces on my site(proposed minus existing to be removed/replac S.F. (Box <br /> Step 2: Evaluate the three statements below by selecting TRUE or FALSE: <br /> 1. The value of Box +Box 3=Box 1, above.(circle one) Reserved for City of Everett Public Works Approval Stamp <br /> ANSWER: TRUE or FALSE <br /> *If False,re-eva your areas and try again. <br /> 2. The value in Box 1 above is 2,000 square feet or more. (circle one) APPROVED <br /> ANSWER: TRUE or FALS PUBLIC WOR DEPART E T <br /> *If False,only complete General In ormation&Construction Stormwater Plan. BY <br /> 3. The value in Box 3 above is less than 5,000 square feet. (circle one) DATE <br /> CITY OF EVERETT REVIEWED FOR PERMIT <br /> ANSWER: or FALSE "RE.[zoo i—azS <br /> *If False,submit an Engineered Drainage Report addressing MR#1-9. <br /> Step 3:Proceed with this entire Questionnaire if all 3 answers above are TRUE. <br /> General Information: <br /> Project Site Address: "/ -I <br /> Prepared By: , it/ ~��'�- d <br /> Date Prepared:,4 gw5'r-- /5 2' <br /> Existing Site Information: <br /> 1. Please describe the existing structures,hard surfaces,slopes,drainage patterns,drainage <br /> pipes,vegetation,etc. rj� �/arrtfi* x ` r ` <br /> 4c sir s, yL m <br /> J.V4.f <br /> fi <br /> 2. Please provide the following quantities of existing hard surfaces in square feet: <br /> Existing Roof Area: <br /> Existing Other Hard Surfaces(pavement,gravel,etc.): <br /> i`1 :,l 1 Qa_ge of 7 <br />